Stumbling Into Child Abuse Pediatrics

Antoinette L. Laskey, MD, MPH, FAAP, is an associate professor of pediatrics and division chief and medical director at the Center for Safe and Healthy Families at the Primary Children’s Medical Center at the University of Utah in Salt Lake City. She is an alumna of the Robert Wood Johnson Foundation (RWJF) Clinical Scholars program (2001-2003).

During medical school at the University of Missouri-Columbia, I had my first exposure to child abuse pediatrics. As a third-year student on my pediatrics clerkship, I had the opportunity to participate in the care of a child whom I suspected had been beaten. From that point forward I knew this was where I wanted to spend my career.

I started looking into fellowship opportunities even before I had started my residency. Early in my intern year in 1998, I reached out to Des Runyan, MD, DrPH, a pioneer in child abuse pediatrics and an alumnus of the RWJF Clinical Scholars program (1979-1981) who was then at University of North Carolina at Chapel Hill and who is now national program director of the RWJF Clinical Scholars program. We arranged a visit so that I could learn more about the field through his expert eyes.

Before child abuse pediatrics was recognized as an official subspecialty of pediatrics, there were two different paths to enter practice: a one-year “apprenticeship” or a two-year clinical and research fellowship. In my short visit to Chapel Hill, it became apparent to me that an RWJF Clinical Scholars position was the way I needed to go to not only practice in the field of child abuse pediatrics but to also gain the knowledge base necessary to move the field forward.

I had so many questions that I wanted to answer: Why did health care providers miss abusive head trauma? What factors about a child or a clinician influenced whether a case would be classified as child abuse? What could we do to improve our clinical accuracy?

I was afforded the chance to take on these issues as a Clinical Scholar at the University of North Carolina-Chapel Hill from 2001-2003. During my time as a scholar, I worked toward my master’s degree in public health—an invaluable tool in my arsenal as I work with my colleagues nationally to spread the message that child abuse is not only a social problem but also a public health problem. Research continues to accumulate making it clear that children impacted by family violence go on to suffer lifelong health consequences. These consequences drive up health care costs, decrease productivity and can create cycles of victimization.

My exposure to diverse viewpoints, public health leaders, politicians and policy-makers during my Clinical Scholar years has served as a foundation for all my work thus far. The experience of having colleagues from different fields training together teaches an important skill in my field: the ability to communicate across disciplines. It is essential that clinicians and researchers in child abuse pediatrics are able to effectively communicate and collaborate with others who aren’t necessarily on the front line of these types of cases. Without this skill, we are simply preaching to the choir.

My time as a Clinical Scholar also led to lifelong collaborative research partners including Carole Jenny, MD, MBA (1974-1976), Stephen Downs, MD, MS, (1989-1991), and, of course, Des Runyan, to name just a few.

In the 10 years since I graduated from the program I have taken the skills I acquired and applied them in several settings: as chair of a state fatality review team, as a fellowship director, a research mentor, a researcher, a teacher, an advocate for children and a clinician.

My current job allows me to work with colleagues in both medical care for the potentially abused child as well as the therapists who treat trauma-affected children. I work with state-level agencies to improve the health and safety of children and reduce the impact of family violence in our community. I collaborate with researchers around the country and here in my own program to truly move our field forward.

I feel very fortunate to have stumbled onto a career path and to have been wisely guided to a program that has allowed me to have such rich and diverse experiences.

RWJF Clinical Scholars have played a critical role in the development of the medical subspecialty of child abuse pediatrics. Read more about their important work here. Read a blog post on child abuse prevention by Clinical Scholars program alumnus Brendan Campbell here and another one by Clinical Scholars program alumna Andrea Asnes here.

This commentary originally appeared on the RWJF Human Capital Blog. The views and opinions expressed here are those of the authors.